INHALED VERSUS SYSTEMIC STEROIDS IN CHRONIC OXYGEN DEPENDENCY OF PRETERM INFANTS

The speed of action and side-effects of systemic versus inhaled steroi ds was compared in infants with mild-moderate oxygen dependency. Forty infants (median gestational age 27 weeks) were randomized to receive either 10 days of dexamethasone (systemic group) or budesonide (100 mu g qds) (inhaled group). At randomization, there was no significant di fference in the gestational or postnatal age, inspired oxygen requirem ents or compliance of the respiratory system of the two groups. After 36 h of treatment, there were significant changes (P < 0.01) in both t he inspired oxygen concentration and compliance of the respiratory sys tem in the systemic but not the inhaled group. Only after 1 week of in haled therapy were improvements in respiratory status noted but, even at that time, the inspired oxygen requirement was significantly lower in the systemic versus the inhaled group. In the systemic group only, however, were there significant increases in blood pressure. Conclusio n Systemically administered rather than inhaled steroids appear to hav e a faster onset of action.